Medical Surgical Nursing

• Restricted activity


• Stool impaction

Urinary Incontinence

• Types

1. Stress incontinence is the involuntary loss of urine through an intact urethra as

a result of sneezing, coughing, or changing position

2. Urge incontinence is the involuntary loss of urine associated with a strong urge

to void that cannot be suppressed. The patient is aware of the need to void but is

unable to reach a toilet in time

3. Reflex incontinence is the involuntary loss of urine due to hyperreflexia in the

absence of normal sensations usually associated with voiding. This commonly

occurs in patients with spinal cord injury because they have neither

neurologically mediated motor control of the detrusor nor sensory awareness of

the need to void

4. Overflow incontinence is the involuntary loss of urine associated with

overdistention of the bladder. Such overdistention results from the bladder's

inability to empty normally, despite frequent urine loss. Both neurologic

abnormalities (eg, spinal cord lesions) and factors that obstruct the outflow of

urine (eg, tumors, strictures, and prostatic hyperplasia) can cause overflow

incontinence

5. Functional incontinence refers to those instances in which lower urinary tract

function is intact but other factors, such as severe cognitive impairment (eg,

Alzheimer's dementia), make it difficult for the patient to identify the need to

void or physical impairments make it difficult or impossible

6. Iatrogenic incontinence refers to the involuntary loss of urine due to extrinsic

medical factors, predominantly medications. One such example is the use of

alpha-adrenergic agents to decrease blood pressure.

7. Mixed

Urinary Incontinence - Treatment

• Medications
  
  
  • Anticholinergic agents
  
  
  • alpha-adrenergic
  
  
  • Estrogen therapy